What is the relationship between myofascial trigger points and migraine headaches? What role do trigger points play in therapy?—MOLLY HOGAN, NP, Sausalito, Calif.

Myofascial trigger points are thought to mediate vascular and muscular tone in the areas they affect. By stimulating these points (usually through massage or deep pressure), related tissue is affected in such a way as to ease tension, improve circulation, and relieve pain. Concomitant release of certain pain-mediating neurochemicals, such as endorphins, is also thought to occur.—Sherril Sego, FNP-C, DNP (147-12)